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Another study found that one week of creatine supplementation at 25 g/day enhanced muscular performance during repeated sets of bench press and jump squat exercise. Creatine supplementation appeared to allow the subjects to complete their workouts at a higher intensity. The researchers concluded that, over time, working at higher intensities may provide a more intense training stimulus and improved muscular adaptations .
Kerksick, C. M., Wilborn, C. D., Campbell, W. I., Harvey, T. M., Marcello, B. M., Roberts, M. D., Parker, A. G., Byars, A. G., Greenwood, L. D., Almada, A. L., Kreider, R. B., and Greenwood, M. The effects of creatine monohydrate supplementation with and without D-pinitol on resistance training adaptations. J.Strength.Cond.Res. 2009;23:2673-2682. View abstract.
MuscleTech Cell-Tech could also be a solid pick for muscle growth. Detractors may not be a fan of the artificial ingredients, but there is evidence that including carbohydrates and alpha-lipoic acid with creatine may increase muscle creatine content. That said, this product uses a little less alpha-lipoic acid than was used in the study suggesting this synergistic effect.
Some ingredients found in dietary supplements marketed for bodybuilding or performance enhancement—such as whey protein, creatine, and caffeine—generally aren’t associated with any serious safety concerns (when used appropriately). However, they still have the potential for side effects. Before you take any dietary supplement, talk to your healthcare provider. You also can read the articles below about some of these ingredients:
Different forms of creatine in combination with other sports supplements as well as varying doses and supplementation methodology should continue to be researched in an attempt to understand further application of creatine to increase sports and exercise performance of varying disciplines. It is important to remain impartial when evaluating the safety of creatine ingested as a natural supplement. The available evidence indicates that creatine consumption is safe. This perception of safety cannot be guaranteed especially that of the long term safety of creatine supplementation and the various forms of creatine which are administered to different populations (athletes, sedentary, patient, active, young or elderly) throughout the globe.
In particular situations, a coach may advise performing the valsalva maneuver during exercises which place a load on the spine. The vasalva maneuver consists of closing the windpipe and clenching the abdominal muscles as if exhaling, and is performed naturally and unconsciously by most people when applying great force. It serves to stiffen the abdomen and torso and assist the back muscles and spine in supporting the heavy weight. Although it briefly increases blood pressure, its is still recommended by weightlifting experts such as Rippetoe since the risk of a stroke by aneurysm is far lower than the risk of an orthopedic injury caused by inadequate rigidity of the torso. Some medical experts warn that the mechanism of building "high levels of intra-abdominal pressure (IAP)...produced by breath holding using the Valsava maneuver", to "ensure spine stiffness and stability during these extraordinary demands", "should be considered only for extreme weight-lifting challenges — not for rehabilitation exercise".
Rheumatoid arthritis. Early research shows that taking creatine by mouth daily increases lean muscle mass and may improve muscle strength, but does not improve physical functioning in adults with rheumatoid arthritis. In children, taking a specific supplement containing creatine and fatty acids twice daily for 30 days might reduce pain and swelling. But the effects of creatine alone are not clear.
Nephrotoxic drugs. Because taking high doses of creatine might harm your kidneys, there is concern about combining creatine with drugs that might damage the kidneys (nephrotoxic drugs). Potentially nephrotoxic drugs include nonsteroidal anti-inflammatory drug (NSAIDs) such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve, others), cyclosporine (Neoral, Sandimmune) and others.
The maximum amount of creatine the body can store is about 0.3 gram per kilogram of body weight . The creatine content of skeletal (voluntary) muscles averages 125 millimoles per kilogram of dry matter (mmol/kg/dm) and ranges from about 60 to 160 mmol/kg/dm. Approximately 60% of muscle creatine is in the form of PCr. Human muscle seems to have an upper limit of creatine storage of 150 to 160 mmol/kg/dm. Athletes with high creatine stores don't appear to benefit from supplementation, whereas individuals with the lowest levels, such as vegetarians, have the most pronounced increases following supplementation. Without supplementation, the body can replenish muscle creatine at the rate of about 2 g/day .
Safety. Excess quantities of antioxidants may produce a ‘pro-oxidant’ effect, which is the opposite of what you would take these supplements for. The Australian Institute of Sport recommends that antioxidant vitamin supplements only be taken for a period of a few weeks while the body adjusts to stressful circumstances. Excess vitamin C may promote excess iron absorption, which may not be healthy for everyone.
Creatine is a natural source of energy for muscle contraction. The body produces creatine in the liver, kidneys, and pancreas. People can also get creatine by eating meat or fish. (Vegetarians may have lower amounts of creatine in their bodies.) Most of the creatine in the body is stored in skeletal muscle and used during physical activity. The rest is used in the heart, brain, and other tissues.
Creatine is a hydrophilic polar molecule that consists of a negatively charged carboxyl group and a positively charged functional group . The hydrophilic nature of creatine limits its bioavailability . In an attempt to increase creatines bioavailability creatine has been esterified to reduce the hydrophilicity; this product is known as creatine ethyl ester. Manufacturers of creatine ethyl ester promote their product as being able to by-pass the creatine transporter due to improved sarcolemmal permeability toward creatine . Spillane et al  analyzed the effects of a 5 days loading protocol (0.30 g/kg lean mass) followed by a 42 days maintenance phase (0.075 g/kg lean mass) of CM or ethyl ester both combined with a resistance training program in 30 novice males with no previous resistance training experience. The results of this study  showed that ethyl ester was not as effective as CM to enhance serum and muscle creatine stores. Furthermore creatine ethyl ester offered no additional benefit for improving body composition, muscle mass, strength, and power. This research did not support the claims of the creatine ethyl ester manufacturers.